王子醫師部落格

---

國際肝臟研究學會於1999年將超級性肝衰竭定義為病情不超過十天，猛爆性肝衰竭病情介於十至三十天，亞急性肝衰竭病情介於5至24週，慢性肝衰竭病情大於28週。臨床診斷急性肝衰竭患者，極度乏力，另有厭食、噁心、嘔吐、腹脹等嚴重消化道症狀。而且短期內黃膽程度持續加深，造成出血傾向明顯，凝血酶原時間活性率小於等於40%，且排除其他原因。

臨床診斷亞急性患者，極度乏力、有顯消化道症狀，而且膽紅素大於正常值上限的十倍，或者每日膽紅素上升大於等於1mg/dL。凝血酶原時間活性率小於等於40%，且排除其他原因。

臨床診斷亞急性肝衰竭患者，在慢性肝病基礎上，短期內發生急性肝功能代償失調。臨床診斷慢性肝衰竭患者，在肝硬化基礎上，肝功能持續減退，而且喪失肝功能代償失調。

急性肝衰竭之臨床表徵，包括腹水、門脈高血壓、肝腦病變、膽紅素升高、白蛋白降低、凝血功能障礙、凝血酶原時間活性率小於等於40%等等。

急性肝衰竭之治療包括：1.支持性療法。2.肝臟移植。3.其他療法。4.監護管理。

急性肝衰竭之具體療法，茲列表如下：
皰疹病毒感染······················································· Acyclovir
Acetaminophen···················································· N-acetylcysteiin
Amanita phalloides··············································· Silibinin
威爾森氏症························································· 肝臟移植
半乳糖血症························································· 去除飲食中乳糖
脂肪酸氧化························································· 葡萄糖靜脈注射
嗜血症侯群························································· Etoposide
血鐵質沉積症······················································ 換血
自體免疫性肝炎··················································· 類固醇